| NPI | 1033771589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201010622) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2022-08-15 |